The activity-based cost of drug-susceptibility test of Mycobacterium tuberculosis through Kit SIRE Nitratase® Plastlabor

Background: Drug-resistant tuberculosis (TB) is an ongoing health threat, and the greatest challenge to adequate control of TB in many countries lies in the lack of proper laboratory drug-susceptibility test. The aim of this study was to evaluate the activity-based costs (ABC) of Kit SIRE Nitratase® (Kit SIRE) and compare its values with the conventional drug-susceptibility test. Methods: The ABC was calculated for three different approaches: Kit SIRE (clinical samples and cultures), proportion methods in Lowenstein Jensen (PM-LJ), and the Bactec™ MGIT™ 960 system based on Mycobacterial Research Laboratory's routine. Results: The ABC of Kit SIRE from cultures was US$ 148.54, while from clinical samples was US$ 136.12. In the case of conventional tests, the ABC of Bactec™ MGIT™ 960 was US$ 227.63 and of the PM-LJ was US$ 132.64. The Kit SIRE has a lower ABC when clinical samples are used instead of cultures. Compared to conventional tests, the ABC is similar to the PM-LJ and lower the Bactec™ MGIT™ 960. Conclusion: The Kit SIRE should be used as a screening method in clinical specimens and in culture for laboratories that do not have Bactec™ MGIT™ 960. Therefore, it can be incorporated into the routine of laboratories in countries with low resources and a high burden of TB and drug-resistant TB.

[1]  P. Phillips,et al.  Cost minimization analysis of line probe assay for detection of multidrug-resistant tuberculosis in Arkhangelsk region of Russian Federation , 2019, PloS one.

[2]  T. Holtz,et al.  Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta-analysis , 2018, The Lancet.

[3]  R. Garfein,et al.  Cost analysis of rapid diagnostics for drug-resistant tuberculosis , 2018, BMC Infectious Diseases.

[4]  A. Kritski,et al.  Evaluation of the Commercial Kit SIRE Nitratase for detecting resistant Mycobacterium tuberculosis in Brazil. , 2017, Revista da Sociedade Brasileira de Medicina Tropical.

[5]  Isabela N. de Almeida,et al.  Evaluation of the Mean Cost and Activity Based Cost in the Diagnosis of Pulmonary Tuberculosis in the Laboratory Routine of a High-Complexity Hospital in Brazil , 2017, Front. Microbiol..

[6]  M. Alonso Custos no serviço público , 2014, Revista do Serviço Público.

[7]  S. Dorman,et al.  Comparison of laboratory costs of rapid molecular tests and conventional diagnostics for detection of tuberculosis and drug-resistant tuberculosis in South Africa , 2013, BMC Infectious Diseases.

[8]  K. Steingart,et al.  Diagnostic Accuracy and Reproducibility of WHO-Endorsed Phenotypic Drug Susceptibility Testing Methods for First-Line and Second-Line Antituberculosis Drugs , 2012, Journal of Clinical Microbiology.

[9]  S. Hoffner,et al.  Field assessment of the direct nitrate reductase assay for rapid detection of multidrug-resistant tuberculosis in Honduras. , 2011, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[10]  D. Falzon,et al.  The impact and cost-effectiveness of strategies to detect drug-resistant tuberculosis , 2011, European Respiratory Journal.

[11]  M. Joloba,et al.  Direct susceptibility testing for multi drug resistant tuberculosis: A meta-analysis , 2009, BMC infectious diseases.

[12]  M. Perkins,et al.  Cost-effectiveness analysis of introduction of rapid, alternative methods to identify multidrug-resistant tuberculosis in middle-income countries. , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[13]  S. Hoffner,et al.  Rapid and Inexpensive Drug Susceptibility Testing of Mycobacterium tuberculosis with a Nitrate Reductase Assay , 2002, Journal of Clinical Microbiology.

[14]  M. Weinstein,et al.  Susceptibility testing for mycobacteria. , 2000, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[15]  F. Portaels,et al.  Evaluation of Mycobacteria Growth Indicator Tube (MGIT) for drug susceptibility testing of Mycobacterium tuberculosis. , 1999, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[16]  C. Dolea,et al.  World Health Organization , 1949, International Organization.

[17]  C. Y. Khoury,et al.  Controvérsias acerca do sistema de custos ABC , 2000 .